RT Journal
A1 Khaodhiar L, Bistrian BR
T1 TOtal parenteral nutrition for critically ill patients
JF JAMA
JO JAMA
YR 1999
FD October 20
VO 282
IS 15
SP 1423
OP 1425
DO 10-1001/pubs.JAMA-ISSN-0098-7484-282-15-jac90009
UL http://dx.doi.org/10-1001/pubs.JAMA-ISSN-0098-7484-282-15-jac90009
AB 
To the Editor: The meta-analysis of total parenteral
nutrition (TPN) in the critically ill patient by Dr Heyland and colleagues1 illustrates several of the serious problems of
meta-analysis compared with randomized clinical trials. These involve heterogeneity
of the trials included, failure of the investigators performing the meta-analysis
to understand the basic issues, and defects in abstracting.2
Several problems illustrate why there should be a reluctance to base clinical
decisions about the use of TPN on the distilled findings from this meta-analysis.